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Hearing
Services
Complete Audiometric Evaluations
Pure Tone Audiometry - air and bone conduction,
Speech Audiometry - speech reception thresholds and speech recognition, Acoustic Immittance Measures-
tympanometry, acoustic reflexes, eustachian tube function
Hearing
Aid Consultations
Evaluations, fittings, dispensing,
repairs
Evoked Potentials Laboratory
Auditory Brainstem Response Evaluations (Neuro-Otologic Evaluations),
Auditory Brainstem Response Evaluations (Threshold Search),
Auditory Evoked Steady State Responses, Electroneuronography (Facial Nerve Studies),
Electrocochleography (Diagnosis of Endolymphatic
Hydrops/Meniere's Disease)
Otoacoustic Emissions
Cochlear
Implantation
Consultations, programming, aural habilitation
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Vestibular
(Balance) Services
Vestibular Testing
Computerized Electronystagmography /
Videonystagmography, Dynamic Platform Posturography, Sinusoidal Harmonic Acceleration
(Rotational Chair)
Vestibular
Rehabilitation
Evaluations,
Treatments
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About
Hearing Loss
One
of the Most Common Health Problems
Hearing loss is a problem shared by many people of all ages. In fact, it is one of the most common health problems reported. Hearing loss may be congenital, hereditary or the result of physical changes within the ear, exposure to toxic medicines, disease,infection or injury; it may occur suddenly, but more often it is gradual process that occurs over time. For 50 years, the New York Eye & Ear Infirmary has been assessing hearing status and providing aural rehabilitation and hearing aid fittings.
How
We Hear Sound waves vibrate the tympanic
membrane, which transmits vibrations through the bones of the middle ear to the cochlea (organ of hearing). Hair cells in the cochlea then transmit sound to the auditory nerve. Hearing loss may be unilateral
(occuring in only one ear) or it may be bilateral (occuring in both ears). Bilateral hearing loss may be symmetrical or nonsymmetrical (the degree, severity and/or configuration of the hearing loss may be different in each ear) Hearing loss resulting from a failure of the physical structures in the outer and middle ear that conduct sound impulses to the nerve center in the inner ear is called a conductive hearing loss . This involves interference of any sort in the transmission of sound from the external auditory canal to the inner ear. Hearing loss resulting from damage to the tiny hair cells that line the inner ear and transmit sound in the form of vibrations to the nerves or damage or injury to any of the structures of the inner ear or the auditory nerve is known as a sensorineural hearing loss. The dysfunction may be in the inner ear, eighth nerve, or in the central auditory pathways. Hearing loss resulting from damage to the physical structures of the outer and/or middle ear and damage to the cochlea or auditory nerve is called a mixed hearing loss. This involves both conductive and sensorineural components.  TOP
You should have your hearing checked if:
- You have to strain to hear normal conversation
- You have to watch other people's faces very carefully to follow what they are saying
- You need to ask people to repeat what they've said
- You often misunderstand what people are saying
- You turn the volume of the television or radio up so high that others complain
- You feel that people are mumbling when they're talking to you
- You are having ear infections, dizziness or a ringing in your ears
- You find that the effort to hear leaves you feeling tired and irritated
- You notice, when using the phone, that you hear better with one ear than the other
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Hearing Loss in Children
The acquisition of language is a time locked, auditory linked process related to early maturational periods in a child's life. It is essentially that any hearing loss be identified as early as possible to insure optimal language development . The nature of hearing losses make it imperative that a team of professionals work together to diagnose a hearing loss and chart the managment of the child with hearing loss. Hearing losses that are present at birth or that present themselves later, but are in the genes at birth, are termed congenital. Some of the known causes of congenital hearing loss are:
- Maternal Rubella
- Cytomegalovirus/Maternal Infection
- Ototoxic and other drugs or maternal alcoholism
- Hypoxia
- Maternal Syphilis
- Parental Ionizing Irradiation during Pregnancy
- Toxoplasmosis
- Recessively inherited deafness
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Hearing loss that occurs after birth is known
as acquired. Some of the known causes of acquired hearing loss are:
- Hypoxia at birth
- Traumatic Delivery
- Premature Delivery
- Infection/High Fevers
- Infantile Measles or Mumps
- Noise Trauma
- Meningitis
- Encephalitis
- Otitis Media (Acute, Chronic, Serous) (most common cause of temporary HL in children)
- Accidents(Trauma) to the Ear or Head
- Ototoxic Drugs
Observations of Infants In Response to Sound:
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Arousal from sleep
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Gross body movements
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Orienting behavior
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Turning of the head
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Wide-eyed "what is it" look
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Pupillary dilatation
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Motor reflexes
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Facial grimaces
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Movement of a finger
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Crying or cessation of crying
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Startle or Moro Reflex (in response to loud sounds)
Before 6 months of age, infants are establishing a language-specific phonetic perceptual auditory base. Children with hearing loss of any degree are likely to demonstrate :
- Vocabulary problems
- Problems with auditory problem solving
- Auditory memory problems
- Problems with receptive language development
- Problems with expressive language development
- Problems with speech production
- Auditory-visual integration problems
- Reading comprehension problems
If responses to auditory stimuli do not appear to be "normal", the child's physician should immediately be contacted and the child's hearing should be assessed by an
audiologist. There are various methods of testing auditory functioning, which allows the behavioral assessment of functional hearing and the objective measurement of the ear's response to auditory stimulation. If the child's speech and language development seems "delayed", the child should receive a complete medical examination, followed by an audiometric evaluation and a speech/language evaluation.
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Vestibular
Testing
Vestibular Services provided by Center for Communicative Sciences at The New York Eye and Ear Infirmary is the most comprehensive program in the New
York metropolitan area. The state of the art Vestibular Laboratory, completed in 1992, facilitates a rapid quantitative functional assessment of patients with dizziness, imbalance, and postural instability. Tests are computerized and are performed by a staff of audiologists and therapists specially trained in vestibular testing.
One of the most important functions of the inner ear and associated nerves is the maintenance of
equillibrium, or balance. As reported by the National Institutes of Health, 42 percent of the population will complain to their doctor of dizziness. An estimated half million people are severely disabled by their symptoms.
Tests developed since 1984 enable physicians to diagnose some vestibular disorders. Diagnostic techniques include:
- Computerized Electronystagmography /
Videonystagmography
Used to assess the site of a lesion and the extent of vestibular damage
- Sinusoidal Harmonic Acceleration Rotational
Chair
The most sensitive test for monitoring compensation in the presence of vestibular dysfunction
- Dynamic Platform Posturography
Provides objective and quantitative measurement of posture, movement, motor control, as well as vestibular and visual deficits associated with the involuntary control of
balance.
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Vestibular Rehabilitation
The Vestibular Rehabilitation Program at The New York Eye and Ear Infirmary has been in place since 1995. In January, 2001, the program was expanded, and now serves as the balance center for all of the member hospitals in The Continuum Health Partners, Inc. This program is run by licensed Physical Therapists, who are specially certified in Vestibular Rehabilitation. New state-of-the -art equipment has been incorporated into the program to enhance the ability to diagnose and treat patients with dizziness and/or imbalance.People who are experiencing dizziness or balance problems may have difficulty performing their normal, everyday activities. Their ability to take care of themselves and their families is often impaired. Working, crossing a street, driving, shopping and going out socially can become difficult, if not impossible. Naturally, these problems create anxiety and stress. Vestibular Rehabilitation is an exercise-based approach to alleviating the symptoms associated with these disorders. The objective of the program is to ensure that patients are able to return to as much function as possible, with little or no remaining symptoms. Patients must be referred for therapy by a physician. They will be evaluated by a physical therapist who will set up an individualized program to meet their specific needs. Therapy sessions are set up on a weekly basis with the patient being responsible for performing a home exercise plan between sessions. The therapy program may last for a period of 2 to 6 months. Patients with suspected vestibular disorders should be seen by an otolaryngologist who specializes in disorders of the inner ear, and in vestibular testing, and rehabilitation. For a medical referral or for information on vestibular
services, please call (212) 979-4699.
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Hearing & Balance Staff
Clinical
Director
Randy
B. Judson, Au.D./CCC-A/F-AAA
Hearing Scientist
Carol Silverman, Ph.D./M.PH./CCC-A
Coordinator-Hearing Aid Dispensary
Elizabeth Levine-Davis, MA/CCC-A/F-AAA
Vestibular Rehabilitation Director
Linda Vetere, BS/PT
Audiologists
Randi Botier, Au.D/CCC-A, Supervisor
Katherine Brusca, MA/CCC-A
Jennifer Jones, MS/CCC-A
Sharon Kupfer, MS/CCC-A, Supervisor
Tracey Lynch, MS/CCC-A
Sara Marschall, Au.D.
Sara Natter, MS/CCC-A/F-AAA
Jessica O'Gara, MS/CCC-A/F-AAA, Supervisor
Melissa Siegel, Au.D./CCC-A/F-AAA
Senior Physical Therapists
Laura Lei-Rivera, BS/PT
Anu Abraham, D.PT
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